不同类型呼吸道感染患儿器官功能损伤情况及预后影响因素分析

Analysis of Organ Function Damage and Prognostic Factors in Children with Different Types of Respiratory Tract Infection

目的:分析讨论不同类型呼吸道感染患儿器官功能损伤情况及预后的影响因素。方法:收集2016年1月至2016年12月我院就诊并接受治疗的74例呼吸道感染患儿的临床资料进行回顾性分析。根据感染类型不同将患儿分为上呼吸道感染(URTI)组和肺炎组,采集两组患儿临床资料、生化指标,利用血细胞分析、胸部正位片等检查患儿器官功能损伤情况;随访截止至2018年12月31日,观察各组患儿预后情况,采用单因素及多因素Logistic分析影响呼吸道感染患儿的危险因素。结果:URTI组出现心血管系统受损者5例(14.28%)明显少于肺炎组的19例(48.72%),差异有统计学意义(χ^2=9.98,P=0.02);URTI组出现消化系统异常者6例(17.14%),肺炎组消化系统异常者21例(53.85%),差异有统计学意义(χ^2=10.723,P=0.001);截止至2018年12月31日,URTI组全部治愈35例(100.00%),肺炎组治愈或好转32例(82.05%);单因素分析结果显示:肺炎患儿预后不良与预后良好者在年龄、哮喘、ALT异常、消化系统异常、重症肺炎人数及降钙素原(PCT)水平间差异均有统计学意义(均P<0.05);多因素分析显示:CK-MB异常、PCT水平是影响肺炎患儿预后的独立危险因素(P<0.05)。结论:与URTI组比,肺炎患儿器官功能损伤更为严重;而CK-MB>24U/L和PCT水平是影响肺炎患儿预后的危险因素,临床可以通过控制以上因素,减少呼吸道感染的发生率。

Objectives:To analyze and discuss the organ function damage and the influencing factors of prognosis in children with different types of respiratory tract infection.Methods:The clinical data of 74 children with respiratory tract infection treated in our hospital from January 2016 to December 2016 were retrospectively analyzed.According to the different types of infection,the children were divided into the upper respiratory tract infection(URTI)group and the pneumonia group,and the clinical data and biochemical indexes of the two groups were collected,and the functional damage of the organs of the children was checked by using the blood cell analysis and the chest positive slice.After follow-up until December 31,2018,the prognosis of children in each group was observed.The risk factors affecting respiratory tract infection were analyzed by univariate and multivariate Logistic.Results:5(14.28%)of the patients with impaired cardiovascular system in the URTI group were significantly lower than that of the pneumonia group(48.72%),and the difference was statistically significant(χ^2=9.98,P=0.02);There were 6 cases(17.14%)with abnormal digestive system in URTI group and 21 cases(53.85%)with abnormal digestive system in pneumonia group,the difference was statistically significant(χ^2=10.723,P=0.001).As of December 31,2018,35 cases(100.00%)were cured in URTI group and 32 cases(82.05%)were cured or improved in pneumonia group.The results of factor analysis showed that there were significant differences in age,asthma,abnormal ALT,abnormal digestive system,the number of severe pneumonia and the level of PCT between the children with pneumonia and those with good prognos is(P<0.05).Multivariate analysis showed that CK-MB was abnormal,and the PCT was an independent risk factor that affected the prognosis of children with pneumonia(P<0.05).Conclusion:Compared with the URTI group,the organ function of the children with pneumonia is more serious;and the CK-MB>24U/L and PCT are the risk factors that affect the prognosis of the children with pneumonia,and the clinical can reduce the incidence of respiratory tract infection by controlling the above factors.